Analyzing 11,658 cases, 31.3% were women, 68.7% men; 94.9% involved surgery for diastasis with ventral hernias. Preferred techniques: mini-less-open and endoscopic sublay (48.9%), open techniques (30.7%), laparoscopic (11.0%). Postoperative complications were 5% with a 2.3% reoperation rate, indicating surgical challenges. Surgeons should consider patient selection carefully, as outcomes highlight the complexity of these procedures. Journal […]
Category: General Surgery
Training Residents on Intraoperative DNR Improves Confidence
Surgeon education on intraoperative do not resuscitate (DNR) orders is crucial for enhancing patient care and respecting autonomy. 56.5% of surgery residents mistakenly thought DNR status must be revoked for elective surgeries; 52.1% believed this for emergencies. A simulation-based curriculum significantly boosted residents’ confidence (p < .001) and corrected misconceptions regarding DNR status preservation (p […]
New Machine Learning Tool Improves Social Risk Assessment for Surgery
A new machine learning-based index enhances social risk evaluation in surgical patients, crucial for better outcomes and health equity. Models using machine learning outperformed conventional indices, showing a median 8.15-fold increase in predictive power across 14 surgical outcomes. The study analyzed over 3.2 million patients from 688 hospitals, providing tailored social risk insights for different […]
New Endpoint May Streamline Trials for Colon and Liver Surgery
A composite endpoint approach can help assess outcomes in simultaneous resections for colon cancer with synchronous liver metastases, improving clinical trial efficiency. In a study of 1,591 patients, 24.3% had a positive composite postoperative endpoint (CELCSS), indicating potential complications. CELCSS includes key issues like colon anastomotic leak (15.4%) and postoperative bleeding (6.5%), predicting prolonged hospital […]
Thoracoscopic Oesophagectomy Matches Open Approach in Cancer Patients
Thoracoscopic oesophagectomy is non-inferior to open oesophagectomy regarding overall survival for resectable thoracic oesophageal cancer. 300 patients were studied: 150 underwent open surgery, 150 had the thoracoscopic procedure. At the first interim analysis (1.6 years median follow-up), overall survival was statistically preserved for the thoracoscopic group (HR 0.56). Consider thoracoscopic approaches to enhance patient recovery […]
Transcylindrical Cholecystectomy: Fast, Safe, and Effective
Transcylindrical cholecystectomy offers a promising outpatient option for treating cholelithiasis with minimal complications. Operative time averages 40 minutes with a low conversion rate of 0.9%. Complication rates include 2.2% wound infections, 0.5% bile leaks, and 0.1% mortality. Most patients (78%) report good to excellent condition within 24 hours. Consider this technique for low-risk patients, particularly […]
Improved Survival in Gallbladder Cancer Post-Surgery
Textbook outcomes in liver surgery link directly to better survival in gallbladder cancer patients. 61.9% of patients achieved textbook outcomes (TOLS) after curative-intent resection. The 5-year overall survival rate was 45.4% in the TOLS group compared to 21.9% for non-TOLS (p < 0.001). Surgeons should prioritize achieving TOLS to improve long-term patient outcomes. Key risk […]
Proactive Laparoscopic Cholecystectomy Safe for Complex Cases
Surgeons can confidently perform proactive emergency laparoscopic cholecystectomy for complex acute cholecystitis, showing strong outcomes even in high-risk patients. Among 721 patients, the overall complication rate was just 6.9%, with severe complications at 1.2%. Patients older than 80 had no higher complication rates (p = 0.14) compared to younger patients. Indocyanine green cholangiography significantly reduced […]
Biliary Stenting with Radioactive Seeds Enhances Survival in Cholangiocarcinoma
Combining biliary stenting with intraluminal 125 I seed brachytherapy significantly improves outcomes for advanced cholangiocarcinoma patients. Patients receiving the combination treatment had a longer overall survival and better stent patency (p < 0.001) compared to those with stenting alone. Complication rates were comparable between both groups, indicating safety (p > 0.85). Integrating this technique could […]
Effective TROPIS Procedure for High Complex Anal Fistulas
The TROPIS procedure shows promise for treating high complex anal fistulas with strong outcomes. One-time cure rate stands at 80% with a final cure rate of 89%. Recurrence rate after initial surgery is low at 20%, with no reported adverse events. Consider adopting TROPIS as a viable option in surgical practice for this challenging condition. […]